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https://www.readbyqxmd.com/read/28340259/sedative-prescriptions-are-common-at-opioid-initiation-an-observational-study-in-the-veterans-health-administration
#1
Hilary J Mosher, Kelly K Richardson, Brian C Lund
Background.:  Concurrent use of sedatives, especially anxiolytics, and opioids is associated with increased risk of medication-related harms. To the extent that multiple prescribers are involved, approaches to influence patterns of coprescribing will differ from those to influence prescribing within a single drug class. Objectives.:  Describe the proportion of new opioid recipients with concurrent sedative medications at opioid initiation and determine whether these medications were prescribed by the same prescriber...
March 18, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28339199/structure-based-discovery-of-new-antagonist-and-biased-agonist-chemotypes-for-the-kappa-opioid-receptor
#2
Zhong Zheng, Xi-Ping Huang, Thomas J Mangano, Rodger Zou, Xin Chen, Saheem Zaidi, Bryan L Roth, Raymond C Stevens, Vsevolod Katritch
The ongoing epidemics of opioid overdose raises an urgent need for effective anti-addiction therapies and addiction-free painkillers. The κ-opioid receptor (KOR) has emerged as a promising target for both indications, raising demand for new chemotypes of KOR antagonists, as well as G-protein-biased agonists. We employed the crystal structure of the KOR-JDTic complex and ligand-optimized structural templates to perform virtual screening of available compound libraries for new KOR ligands. The prospective virtual screening campaign yielded a high 32% hit rate, identifying novel fragment-like and lead-like chemotypes of KOR ligands...
March 24, 2017: Journal of Medicinal Chemistry
https://www.readbyqxmd.com/read/28337672/fentanyl-formulations-in-the-management-of-pain-an-update
#3
REVIEW
Stephan A Schug, Sonya Ting
Fentanyl is a synthetic, highly selective opioid with many desirable physicochemical properties, including a high lipophilicity and predictable pharmacokinetics. These properties have an established record in the management of pain in a variety of settings, particularly acute pain and breakthrough cancer pain. Fentanyl was initially developed for parenteral use; however, this is invasive and impractical in the outpatient setting. Unfortunately, the high first-pass metabolism of fentanyl makes oral formulations unfeasible...
March 23, 2017: Drugs
https://www.readbyqxmd.com/read/28333299/bilateral-breast-reduction-without-opioid-analgesics-a-comparative-study
#4
Fereydoun Don Parsa, Justin Cheng, Brad Stephan, Nikki Castel, Leslie Kim, Daniel Murariu, Alan A Parsa
Background: Breast reduction has traditionally been performed under general anesthesia with adjunct opioid use. However, opioids are associated with a wide variety of adverse effects, including nausea, vomiting, constipation, postoperative sedation, dizziness, and addiction. Objectives: This study compares bilateral breast reduction using a multimodal opioid-free pain management regimen vs traditional general anesthesia with adjunct opioids. Methods: A total of 83 female patients were enrolled in this study...
March 3, 2017: Aesthetic Surgery Journal
https://www.readbyqxmd.com/read/28320888/mutual-reinforcement-of-pathophysiological-host-microbe-interactions-in-intestinal-stasis-models
#5
Ketrija Touw, Daina L Ringus, Nathaniel Hubert, Yunwei Wang, Vanessa A Leone, Anuradha Nadimpalli, Betty R Theriault, Yong E Huang, Johnathan D Tune, Paul B Herring, Gianrico Farrugia, Purna C Kashyap, Dionysios A Antonopoulos, Eugene B Chang
Chronic diseases arise when there is mutual reinforcement of pathophysiological processes that cause an aberrant steady state. Such a sequence of events may underlie chronic constipation, which has been associated with dysbiosis of the gut. In this study we hypothesized that assemblage of microbial communities, directed by slow gastrointestinal transit, affects host function in a way that reinforces constipation and further maintains selection on microbial communities. In our study, we used two models - an opioid-induced constipation model in mice, and a humanized mouse model where germ-free mice were colonized with stool from a patient with constipation-predominant irritable bowel syndrome (IBS-C) in humans...
March 2017: Physiological Reports
https://www.readbyqxmd.com/read/28306581/spinal-cord-stimulation-treatment-for-persistent-pain-after-a-burn-injury-a-case-report
#6
Takeshi Kubota, Yuuhei Ishikawa, Rie Ishikawa
Spinal cord stimulation (SCS) is used to treat neuropathic pain, but there are no published studies on its use to treat burn pain. We used SCS to treat a 67-year-old man suffering from burn pain that could not be managed with high-dose opioids or adjuvant neuropathic analgesics. A trial of SCS markedly reduced the visual analog scale score for pain in the left lateral abdominal and gluteal regions. He underwent permanent implantation of a SCS and achieved an opioid-free state. This case suggests that SCS treatment is a therapeutic option for burn pain refractory to conventional therapy...
March 16, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28301454/characteristics-of-initial-prescription-episodes-and-likelihood-of-long-term-opioid-use-united-states-2006-2015
#7
Anuj Shah, Corey J Hayes, Bradley C Martin
Because long-term opioid use often begins with treatment of acute pain (1), in March 2016, the CDC Guideline for Prescribing Opioids for Chronic Pain included recommendations for the duration of opioid therapy for acute pain and the type of opioid to select when therapy is initiated (2). However, data quantifying the transition from acute to chronic opioid use are lacking. Patient records from the IMS Lifelink+ database were analyzed to characterize the first episode of opioid use among commercially insured, opioid-naïve, cancer-free adults and quantify the increase in probability of long-term use of opioids with each additional day supplied, day of therapy, or incremental increase in cumulative dose...
March 17, 2017: MMWR. Morbidity and Mortality Weekly Report
https://www.readbyqxmd.com/read/28298760/the-effectiveness-of-intravenous-dexmedetomidine-on-perioperative-hemodynamics-analgesic-requirement-and-side-effects-profile-in-patients-undergoing-laparoscopic-surgery-under-general-anesthesia
#8
Vinayak Panchgar, Akshaya N Shetti, H B Sunitha, Vithal K Dhulkhed, A V Nadkarni
BACKGROUND: There is an upward surge in the use of laparoscopic surgeries due to various advantages when compared to open surgeries. Major advantages are, due to small incisions which are cosmetically acceptable and most of them are now daycare procedures. Problem of economic burden and hospital bed occupancy has been overcome with laparoscopic surgeries. All these advantages are not free from disadvantages, as hemodynamic changes such as hypertension; tachycardia and other surgical-related complications are commonly observed intraoperatively...
January 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28292508/pharmacy-based-statewide-naloxone-distribution-a-novel-top-down-bottom-up-approach
#9
Kate J Morton, Brianna Harrand, Carly Cloud Floyd, Craig Schaefer, Julie Acosta, Bridget Claire Logan, Karen Clark
OBJECTIVE: To highlight New Mexico's multifaceted approach to widespread pharmacy naloxone distribution and to share the interventions as a tool for improving pharmacy-based naloxone practices in other states. SETTING: New Mexico had the second highest drug overdose death rate in 2014 of which 53% were related to prescription opioids. Opioid overdose death is preventable through the use of naloxone, a safe and effective medication that reverses the effects of prescription opioids and heroin...
March 2017: Journal of the American Pharmacists Association: JAPhA
https://www.readbyqxmd.com/read/28226338/opioids-inhibit-angiogenesis-in-a-chorioallantoic-membrane-model
#10
Haktan Karaman, Adnan Tufek, Evren Karaman, Orhan Tokgoz
BACKGROUND: Angiogenesis is an important characteristic of cancer. Switching from the avascular phase to the vascular phase is a necessary process for tumor growth. Therefore, research in cancer treatment has focused on angiogenesis as a drug target. Despite the widespread use of opioids to treat pain in patients with cancer, little is known about the effect of these drugs on vascular endothelium and angiogenesis. OBJECTIVES: We aimed to investigate the efficacies of morphine, codeine, and tramadol in 3 different concentrations on angiogenesis in hens' eggs...
February 2017: Pain Physician
https://www.readbyqxmd.com/read/28222927/coping-with-the-enduring-unpredictability-of-opioid-addiction-an-investigation-of-a-novel-family-focused-peer-support-organization
#11
John F Kelly, Nilo Fallah-Sohy, Julie Cristello, Brandon Bergman
BACKGROUND: Opioid overdose deaths have become a major public health crisis. While efforts have focused mostly on helping opioid-addicted individuals directly, family members suffer also from the grave and enduring unpredictability associated with opioid addiction and often play a vital role in helping addicted loved ones access care. Little is known, however, about resources to help affected family members. Here we describe results from the first quantitative and qualitative investigation of a free and growing support organization for family members of addicted individuals ("Learn to Cope" [LTC]; www...
February 17, 2017: Journal of Substance Abuse Treatment
https://www.readbyqxmd.com/read/28220474/buprenorphine-for-managing-opioid-withdrawal
#12
REVIEW
Linda Gowing, Robert Ali, Jason M White, Dalitso Mbewe
BACKGROUND: Managed withdrawal is a necessary step prior to drug-free treatment or as the endpoint of substitution treatment. OBJECTIVES: To assess the effects of buprenorphine versus tapered doses of methadone, alpha2-adrenergic agonists, symptomatic medications or placebo, or different buprenorphine regimens for managing opioid withdrawal, in terms of the intensity of the withdrawal syndrome experienced, duration and completion of treatment, and adverse effects...
February 21, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28215574/the-impact-of-pharmacy-services-on-opioid-prescribing-in-dental%C3%A2-practice
#13
Autumn Stewart, Kelsey J Zborovancik, Kara L Stiely
OBJECTIVES: To compare rates of dental opioid prescribing between periods of full and partial integration of pharmacy services and periods of no integration. METHODS: This observational study used a retrospective chart review of opioid prescriptions written by dental providers practicing in a free dental clinic for the medically underserved over a period of 74 months. Pharmacy services were fully integrated into the practice model for 48 of the 74 months under study...
February 15, 2017: Journal of the American Pharmacists Association: JAPhA
https://www.readbyqxmd.com/read/28199203/neurogenetics-of-acute-and-chronic-opiate-opioid-abstinence-treating-symptoms-and-the-cause
#14
Kenneth Blum, Mark S Gold, William Jacobs, William Vaughn McCall, Marcelo Febo, David Baron, Kristina Dushaj, Zsolt Demetrovics, Rajendra D Badgaiyan
This review begins with a comprehensive history of opioid dependence and treatment in the United States. The focus is an evidence-based treatment model for opioid/opiate dependent individuals. The role of reward genetic polymorphisms and the epigenetic modifications that lead to vulnerability to use and misuse of opiates/opioid to treat pain are reviewed. The neurochemical mechanisms of acute opiate withdrawal and opiate/opioid reward mechanisms are explored with a goal of identifying specific treatment targets...
March 1, 2017: Frontiers in Bioscience (Landmark Edition)
https://www.readbyqxmd.com/read/28182836/an-exploratory-study-evaluating-the-impact-of-opioid-and-non-opioid-pain-medications-on-serum-plasma-free-testosterone-and-free-estradiol-concentrations
#15
Julie A Ray, Mark M Kushnir, A Wayne Meikle, Jill E Sindt, Frederick G Strathmann
Chronic use of opioid medications has been reported to cause altered sexual function. It is not known if non-opioid pain medications have similar effects. Assessment of this effect through the measurement of concentrations of free hormones is limited. Positivity of opioid medications (hydrocodone, oxycodone, morphine, methadone, tramadol and fentanyl) and non-opioid pain medications (gabapentin or pregabalin) in human serum and plasma samples from adult men and women were evaluated for association with concentrations of free testosterone (fTe) and free estradiol (fE2) measured using equilibrium dialysis-liquid chromatography-tandem mass spectrometry methods...
February 9, 2017: Drug Testing and Analysis
https://www.readbyqxmd.com/read/28166603/electroacupuncture-attenuates-hyperalgesia-in-rats-withdrawn-from-chronic-alcohol-drinking-via-habenular-mu-opioid-receptors
#16
Jing Li, Caihong Fu, Hongwei Liu, Rao Fu, Wanhong Zuo, Seungwoo Kang, Pei Chen, Danielle Gregor, Rose Paulose, Alex Bekker, Jiang-Hong Ye
BACKGROUND: Hyperalgesia or increased sensitivity to pain is often found in alcoholics during alcohol withdrawal and may contribute to relapse drinking. Alternative therapies such as acupuncture and electroacupuncture (EA), through mechanisms involving opioid receptors, may reduce pain and substance dependence and withdrawal syndromes. The lateral habenula (LHb), an epithalamic structure rich in mu opioid receptors (MORs), is a critical target for both drugs of abuse and pain. We previously observed hyperalgesia in rats withdrawn from chronic ethanol (EtOH) drinking and found that EA at the acupoint Zusanli (ST36) reduced EtOH intake...
March 2017: Alcoholism, Clinical and Experimental Research
https://www.readbyqxmd.com/read/28155294/pulmonary-gas-exchange-and-acid-base-status-during-immobilisation-of-black-rhinoceroses-i-diceros-bicornis-i-in-zimbabwe
#17
Åsa Fahlman, Anna Edner, Sandra Wenger, Chris Foggin, Görel Nyman
When immobilising wildlife, adverse side effects can include hypoxaemia, acidosis and hypertension. Pulmonary gas exchange and acid-base status were evaluated during immobilisation of 25 free-ranging and one boma-held black rhinoceros (Diceros bicornis) in Zimbabwe. The effect of different body positions on arterial oxygenation was evaluated. A combination of the following drugs was used: an opioid (etorphine or thiafentanil), azaperone and an a2 -adrenoceptor agonist (detomidine or xylazine). Respiratory and heart rates, rectal temperature and pulse oximetry-derived haemoglobin oxygen saturation were recorded...
December 2, 2016: Journal of the South African Veterinary Association
https://www.readbyqxmd.com/read/28144724/pharmacokinetics-of-a-new-nasal-formulation-of-naloxone
#18
Ida Tylleskar, Arne Kristian Skulberg, Turid Nilsen, Sissel Skarra, Phatsawee Jansook, Ola Dale
PURPOSE: Nasal naloxone is wanted for bystander administration in opioid overdose and as a needle-free alternative for emergency medical personnel. Epidemiologic studies have indicated a therapeutic effect of bystander administration of low-concentration/high-volume formulations. The objective for this study was to describe the nasal pharmacokinetics of a new high-concentration/low-volume nasal formulation of naloxone. METHODS: This was an open, randomized triple crossover trial in healthy, human volunteers (n = 12) where two doses of nasal naloxone (0...
January 31, 2017: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28130810/shift-in-disparities-in-hepatitis-c-treatment-from-interferon-to-daa-era-a-population-based-cohort-study
#19
N Z Janjua, N Islam, J Wong, E M Yoshida, A Ramji, H Samji, Z A Butt, M Chong, D Cook, M Alvarez, M Darvishian, M Tyndall, M Krajden
We evaluated the shift in the characteristics of people who received interferon-based hepatitis C virus (HCV) treatments and those who received recently introduced direct-acting antivirals (DAAs) in British Columbia (BC), Canada. The BC Hepatitis Testers Cohort includes 1.5 million individuals tested for HCV or HIV, or reported cases of hepatitis B and active tuberculosis in BC from 1990 to 2013 linked to medical visits, hospitalization, cancer, prescription drugs and mortality data. This analysis included all patients who filled at least one prescription for HCV treatment until 31 July 2015...
January 27, 2017: Journal of Viral Hepatitis
https://www.readbyqxmd.com/read/28092334/is-enhanced-recovery-the-new-standard-of-care-in-microsurgical-breast-reconstruction
#20
Anoushka Afonso, Sabine Oskar, Kay See Tan, Joseph J Disa, Babak J Mehrara, Jihan Ceyhan, Joseph H Dayan
BACKGROUND: Enhanced recovery pathways (ERPs) have been shown to aid in patient recovery and improve outcomes in many surgical settings. At present, there is limited data available regarding the use and feasibility of ERPs for patients undergoing microsurgical breast reconstruction. We sought to assess patient outcomes before and after the introduction of an ERP that was adopted by multiple surgeons at a single cancer center. METHODS: A multidisciplinary ERP was developed for patients undergoing deep inferior epigastric perforator (DIEP) or muscle-sparing free transverse rectus abdominis myocutaneous (TRAM) flap breast reconstruction...
January 12, 2017: Plastic and Reconstructive Surgery
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